NIH Launches 'Nerve Stimulation' Trial to Ease Tinnitus
Agency is seeking patients suffering from chronic 'ringing in the ears'
THURSDAY, March 6, 2014 (HealthDay News) -- Volunteers are being recruited for a clinical trial to test a new method to treat ringing in the ears, the troubling condition known as tinnitus.
The technique being studied uses nervous system stimulation to "rewire" parts of the brain in an attempt to significantly reduce or eliminate tinnitus. If it proves successful, it could offer hope to millions of Americans with the disorder, according to the U.S. National Institute on Deafness and Other Communication Disorders (NIDCD), which is funding the study.
"Tinnitus affects nearly 24 million adult Americans," NIDCD director Dr. James Battey Jr. said in a government news release. "It is also the number one service-connected disability for returning veterans from Iraq and Afghanistan. The kind of nervous system stimuli used in this study has already been shown to safely and effectively help people with epilepsy or depression. This therapy could offer a profoundly better way to treat tinnitus."
During therapy, patients hear a series of single-frequency tones through headphones. At the same time, stimulation is delivered to the vagus nerve, which runs from the head and neck to the abdomen. When stimulated, the vagus nerve releases chemicals that can rewire the brain, the researchers explained in the news release.
Previous studies in rats and humans suggested that vagus nerve stimulation could be effective in reducing or eliminating tinnitus, according to the NIDCD.
The new clinical trial will include adults who have had moderate-to-severe tinnitus for at least a year. They will undergo daily 2.5-hour sessions of vagus-nerve stimulation and audio-tone therapy over six weeks.
The trial will be conducted at four centers through an agreement with a Dallas-based medical device company called MicroTransponder, Inc. The centers include the University of Texas at Dallas, University at Buffalo in New York and the University of Iowa. A fourth center will be announced later this year.
"This trial has the potential to open up a whole new world of tinnitus management," Dr. Gordon Hughes, director of clinical trials at the NIDCD, said in the news release.
"Currently, we usually offer patients a hearing aid if they have hearing loss or a masking device if they don't," Hughes said. "None of these treatments cures tinnitus. But this new treatment offers the possibility of reducing or eliminating the bothersome perception of tinnitus in some patients."
The American Academy of Otolaryngology -- Head and Neck Surgery has more about tinnitus (http://www.entnet.org/HealthInformation/tinnitus.cfm ).
SOURCE: U.S. National Institute on Deafness and Other Communication Disorders, news release, March 6, 2014
Hospital Policy Spurs New Moms to Get Whooping Cough Shot
With standing order for vaccine, coverage went from 18 percent to 69 percent, findings showed
THURSDAY, March 6, 2014 (HealthDay News) -- New mothers are much more likely to get a whooping cough shot if hospitals make it a standing order, a new study finds.
Vaccinating new mothers against whooping cough (pertussis) protects both them and their babies against the disease, the study authors say.
Researchers looked at whooping cough vaccination rates among new mothers in two hospitals. One hospital followed standard procedures, while the other first implemented a doctor opt-in order, and then instituted a standing order for new mothers to be given the Tdap vaccine before they left the hospital. The Tdap vaccine protects against tetanus, diphtheria and pertussis.
At the start of the study, the Tdap vaccination rate among new mothers was zero at both hospitals. This increased to 18 percent in the one hospital after it introduced the doctor opt-in order, and to 69 percent when the hospital implemented the standing order, the investigators found.
The findings were published in the March issue of the American Journal of Obstetrics & Gynecology.
"Vaccinating mothers of newborns holds the promise to reduce the risk of whooping cough among infants," Dr. Sylvia Yeh, of the Los Angeles Biomedical Research Institute, said in an institute news release.
"Our study found a simple change in a hospital's standing orders can make a profound difference in the immunization rates of mothers of newborns and provide vital protection to their babies and the rest of their families," she added.
Yeh said that mothers "are likely to agree to be vaccinated if they receive information on the importance of being immunized to protect their children."
Since the study was completed, the U.S. Centers for Disease Control and Prevention Advisory Committee on Immunization Practices has updated its recommendations to say that pregnant women who haven't been vaccinated against whooping cough should be given the vaccination in the latter part of the second trimester or in the third trimester.
Despite the recommendation, research has shown that less than 3 percent of unvaccinated pregnant women receive a Tdap shot, according to the study authors.
The American Academy of Family Physicians has more about whooping cough (http://familydoctor.org/familydoctor/en/diseases-conditions/whooping-cough.printerview.all.html ).
SOURCE: Los Angeles Biomedical Research Institute, news release, March 5, 2014
State Flu Shot Rule for Preschoolers Curbs Kids' Hospitalizations: CDC
When vaccination rates rose in Connecticut, serious complications dropped, report finds
THURSDAY, March 6, 2014 (HealthDay News) -- A Connecticut law requiring flu shots for children entering preschool or daycare has reduced flu-related hospitalizations of young children by 12 percent, according to a new study.
In the United States, Connecticut, New Jersey and New York City are the three places that require a yearly flu shot to stay in daycare or preschool. The Connecticut law took effect in 2010.
"We found that of all the influenza hospitalizations in Connecticut, many fewer were in children 1 to 4 years old after the requirement than before the requirement," said lead researcher Dr. James Hadler, a clinical professor of epidemiology at the Yale School of Public Health.
The jump in flu vaccinations of young children -- to 84 percent in 2012-2013 from about 68 percent in 2009-2010 -- is thought to have caused the decline in hospitalizations, he noted.
"That difference, we feel, has resulted in children attending daycare being better protected against influenza and its severe complications," Hadler said.
Of 11 areas evaluated, Connecticut had the steepest decline in flu hospitalizations of children aged 4 and younger -- a drop of 12 percent between 2007-2008 and 2012-2013, according to the report from the U.S. Centers for Disease Control and Prevention. And the actual rate of hospitalizations for these young children compared to people of other ages was lower in Connecticut than for any of the other regions surveyed.
The report was published in the March 7 issue of the CDC's Morbidity and Mortality Weekly Report.
Young children are at particular risk for severe complications from flu, and they readily transmit the infection, Hadler noted.
"Where there are a lot of susceptible people in a small space, like daycare centers and preschools, you have the potential for easy spread of influenza," Hadler said.
"The kids get it, they give it to each other, they all take it home to their families, the families get it and spread it to other people," he added.
By vaccinating these children, you not only prevent children from getting the flu, but also prevent it from spreading in the community, Hadler explained.
And, he noted, flu shots are free for anyone who has health insurance, including Medicare and Medicaid.
For people who aren't insured, the state provides flu shots for free at community health centers, Hadler pointed out.
Dr. Jose Rosa-Olivares, director of the pediatric care center at Miami Children's Hospital in Florida, said efforts such as the one in Connecticut to standardize vaccination might have benefits.
"We know the proven benefit of the flu vaccine, and the more people that get vaccinated, the better it is for the community," he said.
The U.S. Centers for Disease Control and Prevention recommends that everyone 6 months and older get a flu shot every year.
Another expert thinks that because the flu vaccine has been shown to be effective, it is reasonable to mandate it around the nation before children are allowed to go into daycare or preschool.
"This is not saying that all kids have to have a flu shot. But if you're going into daycare you better have one because you are putting other kids at risk -- and if you don't like it don't go into daycare," said Dr. Marc Siegel, an associate professor of medicine at NYU Langone Medical Center in New York City.
For more information on flu, visit the U.S. Centers for Disease Control and Prevention (http://www.cdc.gov/flu/ ).
SOURCES: James Hadler, M.D., clinical professor of epidemiology, Yale School of Public Health, New Haven, Conn.; Jose Rosa-Olivares, M.D., director, pediatric care center, Miami Children's Hospital; Marc Siegel, M.D., associate professor, medicine, NYU Langone Medical Center, New York City; March 7, 2014, Morbidity and Mortality Weekly Report
Doctors Cautiously Optimistic About 'Cure' for HIV-Infected Babies
Report on second child raises hope that early, aggressive treatment may be game changer for these infants
THURSDAY, March 6, 2014 (HealthDay News) -- The hope that newborns can be "cured" of HIV -- the virus that causes AIDS -- with early, aggressive drug treatment was bolstered this week with the announcement that a second baby appears to be free of the virus following therapy that began just four hours after her birth.
The child, born at Miller Children's Hospital in Long Beach, Calif., is now 9 months old and is considered HIV-negative, researchers reported Wednesday at the Conference on Retroviruses and Opportunistic Infections in Boston.
The first baby apparently cured by early drug therapy -- the so-called "Mississippi baby" -- is now more than 3 years old and also remains free of HIV infection, said Dr. Deborah Persaud, an associate professor of pediatrics in the division of infectious diseases at Johns Hopkins Children's Center in Baltimore.
Persaud, who presented the findings Wednesday on the California baby, has also been involved with continued monitoring of the Mississippi baby.
While the two cases have key differences, taken together they seem to indicate that newborns can be cured of infection with HIV if doctors begin treatment within hours of birth.
A federally funded clinical trial will start within a couple of months to arrive at a more scientific assessment of the treatment, said Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases.
In the trial, as many as 60 babies who are born with HIV will be put on an antiretroviral drug regimen within 48 hours of birth.
The results of the trial could change the way doctors treat HIV-infected newborns, altering thinking that up until now has favored caution because these drugs can be extremely toxic.
"You have to get the data from the trial. You don't want to jump ahead of yourself," Fauci said. "But data that shows when you treat a baby immediately you can actually cure a baby, that changes the equation of risk/benefit. That makes a doctor lean much more toward immediate treatment."
More than 1,000 babies are born with HIV every day around the globe, according to UNICEF.
The mother of the California baby has advanced AIDS and is mentally ill, researchers said. She had been prescribed HIV medications to protect her baby, but had not taken them, according to published reports.
Normally, doctors put children born to HIV-positive mothers on a two-medication regimen until the virus appears in the babies' bloodstream, which can take as long as two weeks. At that point, they move to a more aggressive three-drug regimen.
But in the cases of the Mississippi and California babies, doctors chose to quickly put the newborns on the more aggressive regimen, with stunning results.
Fauci noted that doctors can't yet call the California baby "cured" of HIV infection because she remains on the antiretroviral drug therapy.
"The proof of the pudding is when you take the baby off therapy, and the virus does not bounce back," he said.
The Mississippi baby provides a more striking case because doctors lost track of the mother and child 18 months after her birth, at which point drug therapy ceased. Doctors next saw the child about 10 months later, and were surprised when they found that the girl remained HIV-free despite receiving no further treatment.
"You can say with a much higher degree of confidence that the Mississippi baby is definitely cured," Fauci said.
The timing and the heavy medication dose apparently may have prevented HIV from gaining a foothold in the infants' immune systems, said Dr. Roberto Posada, an associate professor of pediatric infectious diseases at the Icahn School of Medicine at Mount Sinai, in New York City.
HIV typically creates a reservoir in the bodies of those it infects, where it can lay dormant and later return when drug therapy is suspended.
Because adults often don't find out they have been infected until months or years later, it's unlikely that the successful treatment of these babies would have any implications for adult HIV therapy, Posada noted.
"It's difficult to extrapolate these results to adults because babies are so different from adults," he said. "Their immune systems are at a different stage of development, and you know exactly when they have been infected with HIV -- at birth."
At the same time, these findings do emphasize the importance of treating HIV in adults as early as possible, Fauci said.
For more on HIV infection of newborns, visit the U.S. Centers for Disease Control and Prevention (http://www.cdc.gov/hiv/risk/gender/pregnantwomen/facts/ ).
SOURCES: Anthony Fauci, M.D., director, U.S. National Institute of Allergy and Infectious Diseases; Roberto Posada, M.D., associate professor, pediatric infectious diseases, the Icahn School of Medicine at Mount Sinai, New York City
Health Highlights: March 6, 2014
Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:
Lawsuit Launched Against New Abortion Drug Rules in Arizona
Arizona is being taken to court over new rules that limit the use of abortion drugs.
In a lawsuit filed in federal court in Tucson, abortion providers say the new rules -- which are to take effect April 1 -- would prevent many women from having abortions, the Associated Press reported.
Under the rules, the most common abortion drug can be given only at the FDA-approved dosage no later than seven weeks into a pregnancy, rather than nine weeks. Both doses of the drug must be taken at the clinic.
Typically, the drug is taken at home and the dose is lower. If the rules had been in place in 2012, about 800 women would have been forced to undergo surgical abortions instead of using abortion drugs, according to Planned Parenthood Arizona president Bryan Howard, the AP reported.
Federal courts have upheld similar rules for abortion drugs in Ohio and Texas, but state courts in North Dakota and Oklahoma have blocked similar laws.
Early Treatment May Have Cured HIV Infection in Second Baby: Doctors
A second baby who was born with HIV infection may have been cured by receiving treatment soon after birth, doctors said Wednesday at an AIDS conference in Boston.
The first case, which was announced last April and involved a baby girl in Mississippi, made doctors worldwide reconsider how soon and aggressively to treat infants born with HIV, the Associated Press reported.
That baby, who began treatment 30 hours after birth, is now 3 1/2 years old and appears to be HIV-free, even though she hasn't received any treatment for about two years.
In the newer case, the baby girl in Los Angeles received treatment four hours after birth and her HIV infection appears to be in remission, according to doctors. However, the state of her infection is unclear because she is still receiving AIDS medicines.
"We don't know if the baby is in remission ... but it looks like that," Dr. Yvonne Bryson, an infectious disease specialist at Mattel Children's Hospital UCLA who consulted on the girl's care, told the AP.
She added that the medical team is being cautious about claiming the baby girl has been cured, "but that's obviously our hope."
A number of tests suggest that the baby is clear of HIV, according to Dr. Deborah Persaud, a Johns Hopkins University doctor in charge of the testing. The test results are different than those seen in patients whose HIV infections are merely suppressed by treatment, she explained.
The L.A. baby's mother had HIV but was not taking her HIV medicines. She received AIDS drugs during labor in an attempt to protect her baby from infection. But the girl was infected and began treatment a few hours after birth, the AP reported.
The Mississippi girl received HIV drugs until she was 18 months old, at which point the doctors lost contact with her. When they saw her 10 months later, she had no signs of HIV infection even though her mother had not been giving her AIDS medicines.
A new U.S. government study will examine whether very early treatment can cure HIV infection in newborns. It will include about 60 infants in the U.S. and other countries. They will receive very aggressive treatment that will be halted if long-term testing shows they no longer have active infection, the AP reported.
Children's Deaths Highlight Dangers of Storage Chests
The recent suffocation deaths of two children in Massachusetts have prompted federal officials to remind people about the potential dangers of storage, cedar, hope and toy chests.
The brother and sister died in January after they were trapped inside a 75-year-old Lane cedar chest that was recalled in the mid-1990s, the Consumer Product Safety Commission said.
Since 1996, a total of 34 children younger than 18 have died in incidents involving chests. The lids on many chests can automatically latch shut and trap children inside them, or lid supports on chest lids can fail and falling lids can trap children by the head or neck and cause strangulation.
Many homes have older chests that were passed down as family heirlooms or bought used.
The CPSC is working with sellers of used furniture to ensure that store managers and staff do not accept or sell chests that have been recalled or pose a threat to children. The agency also urged people not to buy or sell any recalled chest that has not been repaired.
About 27 companies have taken action to correct more than 14 million storage and toy chests that posed a suffocation, strangulation or injury risk, the CPSC said.
If you have a chest with an automatic latch/lock, disable or remove it. If a chest's lid support does not keep the lid open in every position, replace it with a spring-loaded lid support that keeps the lid open in any position. All toy chest should have ventilation holes that are not blocked by the floor or a wall, the CPSC said.
Health Tip: When Baby's Cries Signal Trouble
Advice for when to call the doctor
(HealthDay News) -- Babies cry as a way to communicate. And sometimes this indicates a serious problem.
The University of Michigan Health System mentions these warning signs of an infant's need for medical attention:
Baby cries non-stop for more than three hours, and the cries are particularly intense or shrill.
Baby just can't be comforted.
Baby's belly is tense or firm.
Baby has never had a crying episode like this.
Baby seems sick or in pain, or has a temperature of more than 100.5 degrees.
Baby has diarrhea or is vomiting.
Hearing Loss Tied to Depression in Study
Women, non-seniors more likely to be affected this way, researchers say
THURSDAY, March 6, 2014 (HealthDay News) -- Hearing loss is associated with depression among American adults, especially women and those younger than age 70, according to new research.
While other studies previously have found the same link, many of them looked only at older adults or at specific regions or ethnicities, and results have been mixed, the researchers pointed out.
In the new study, as hearing declined, the percentage of depressed adults increased -- from about 5 percent in those who had no hearing problems to more than 11 percent in those who did.
"We found a significant association between hearing impairment and moderate to severe depression," said study author Dr. Chuan-Ming Li, a researcher at the U.S. National Institute on Deafness and Other Communication Disorders. "The cause-and-effect relationship is unknown," Li said, citing a need for further studies.
The study was published online March 6 in JAMA Otolaryngology--Head & Neck Surgery.
The new findings make sense, according to two experts in the field who reviewed the study conclusions.
"It is not surprising to me that they would be more likely to be depressed," said James Firman, president and CEO of the National Council on Aging. "People with hearing loss, especially those who don't use hearing aids, find it more difficult to communicate with other people, whether in family situations, social gatherings or at work."
Experts who care for those with hearing loss have long noticed the link, said Robert Frisina, director of the Global Center for Hearing & Speech Research at the University of South Florida, in Tampa. "When they come in [to see about their hearing], they mention this," he said.
Even so, Frisina noted, the study is valuable because it adds solid data to the anecdotal information.
For the new study, the researchers looked at data from the U.S. National Health and Nutrition Examination Survey, including more than 18,000 adults aged 18 and older. The younger people self-reported on their hearing status, while hearing tests were given to those 70 and older. All participants filled out a questionnaire designed to reveal depression.
As hearing loss became worse, the depression did, too, except among those who were deaf. These adults, Frisina said, may be accustomed to coping with the loss.
Hearing loss was linked with an increased risk of depression in adults of all ages, but was most pronounced in the respondents aged 18 to 69, the investigators found. Women had higher rates of depression than men did.
Among those 70 and older, no link was found between self-reported hearing loss and depression. However, a link was found for women in this age group if the hearing test found a hearing loss.
That could be because women start to lose hearing in higher frequencies after age 65, and those frequencies are crucial to understand speech in noisy environments, the study authors noted.
While it is difficult to sort out cause and effect, Frisina said, the researchers did take into account other conditions that could affect hearing, including trouble seeing, and the link held. "It's probably a pretty strong link," he added.
Those who think they are having trouble hearing should seek help, he suggested. Often, family and friends notice the loss first. "If you have hearing loss, you need to go to an audiologist and otolaryngologist and have it diagnosed properly, and then you can look at treatment options," Frisina said.
To learn more about hearing loss, visit the U.S. National Institutes of Health (http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0003535 ).
SOURCES: Chuan-Ming Li, M.D., Ph.D., researcher, U.S. National Institute on Deafness and Other Communication Disorders; Robert Frisina, Ph.D., director, Global Center for Hearing and Speech Research, and professor of chemical and biomedical engineering and communication sciences and disorders, University of South Florida, Tampa; James Firman, Ed.D., president and CEO, National Council on Aging; March 6, 2014, JAMA Otolaryngology--Head & Neck Surgery, online
Kids Lacking At-Home Enrichment Gain Most From Head Start: Study
Researcher says the preschool program is 'vital' for certain children
THURSDAY, March 6, 2014 (HealthDay News) -- Head Start, the U.S. government-funded preschool program, provides the greatest benefits to children whose parents give them little help with learning early in life, new research shows.
The study, published March 6 in the journal Child Development, also found that showing parents how to assist their children with reading and counting may be beneficial.
Head Start offers low-income children preschool education, nutrition services and medical, dental and mental health care. It currently serves more than 1 million children a year.
Researchers analyzed data from nearly 5,000 children, aged 3 and 4, who were enrolled in Head Start. About one-third of the children were black, one-third were Hispanic and one-third were white or other races and ethnicities.
The study found that spending one year in Head Start helped all the children develop early math and literacy skills. However, the benefits were greatest for those whose parents hadn't provided them with early learning stimulation, such as helping them count, reading to them or assisting them in recognizing and pronouncing letters and words.
"These results suggest that it's particularly important that Head Start be offered to those children whose parents did not report providing a lot of pre-academic stimulation," study author Elizabeth Miller, a graduate student in the school of education at the University of California, Irvine, said in a journal news release.
"It's vital that Head Start continue to serve children at the highest and moderate levels of risk because the program is particularly helpful to their development," she added.
"Moreover, our study also suggests that children's academic achievement may benefit from programs targeted to help parents boost preacademic stimulation in the home," Miller said. "Working with parents to increase what they do at home may be an important way Head Start can improve children's readiness for school."
Here's where you can learn more about Head Start (http://www.acf.hhs.gov/programs/ohs ).
SOURCE: Child Development, news release, March 6, 2014
Kids With ADHD May Face Higher Obesity Risk as Teens
Finnish study also found more physical inactivity in this group
THURSDAY, March 6, 2014 (HealthDay News) -- It might seem surprising for a condition with "hyperactivity" in its name, but a new study finds that kids who had attention-deficit/hyperactivity disorder during childhood were more likely to be inactive and obese as teens.
Researchers followed nearly 7,000 children in Finland and found that the 9 percent who had symptoms of ADHD at age 8 were more likely to be physically inactive and obese at age 16.
The investigators also found that children who were less likely to be physically active at age 8 were more likely to have inattention when they were teens.
Moreover, they found that a condition called "conduct disorder," which the researchers said is related to ADHD, increased the risk of teen physical inactivity and obesity. Conduct disorder involves tendencies toward delinquency, rule breaking and violence.
The study was published online recently in the Journal of the American Academy of Child and Adolescent Psychiatry.
"Obesity is a growing problem that we need to watch out for in all children and young people, but these findings suggest that it's particularly important for children with ADHD," senior study author Alina Rodriguez, from the School of Public Health at Imperial College London, said in a college news release.
"It appears that lack of physical activity might be a key factor," Rodriguez said. "We think encouraging children with ADHD to be more physically active could improve their behavior problems as well as helping them to stay a healthy weight. Studies should be carried out to test this theory."
Although the study found an association between childhood ADHD and increased risk for teen inactivity and obesity, it did not establish a cause-and-effect relationship.
Obese children and teens are considered at increased risk for a number of short- and long-term health problems, such as type 2 diabetes, heart disease and mental-health disorders.
The U.S. National Institute of Mental Health has more about attention-deficit/hyperactivity disorder (http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder-easy-to-read/index.shtml ).
SOURCE: Imperial College London, news release, March 4, 2014
Lack of Sleep Compounds Health Problems for Obese Teens: Study
Researchers report it was independently associated with higher risk of heart disease, diabetes
THURSDAY, March 6, 2014 (HealthDay News) -- Obese teens who get too little sleep are at increased risk for heart disease and diabetes, a small study suggests.
Researchers assessed the health, physical activity levels and sleeping habits of 37 obese American youngsters, aged 11 to 17.
Among the study participants, only one-third met the minimum recommendations of being physically active at least one hour per day. Most slept about seven hours a night, typically waking up at least once. Only five got the minimum recommended 8.5 hours of sleep each night.
Too little sleep was associated with an increased risk of heart disease and diabetes, independent of other risk factors, such as lack of physical activity and high levels of body fat, according to the University of Michigan Health System and Baylor University researchers.
The findings, published March 6 in The Journal of Pediatrics, suggest that sleep assessments may be useful in spotting teens at risk for heart disease and diabetes.
Further studies are needed to find out if getting more sleep would help reduce teens' risk for these health problems, lead author Heidi IglayReger, supervisor of the Physical Activity Laboratory at the Michigan Metabolomics and Obesity Center, and colleagues noted in the news release.
Previous research has shown that obesity and lack of sleep are linked with increased risk of heart disease and diabetes in adults and young children, but that association has not been clear in teens, the study authors pointed out.
While the study showed an association between lack of sleep and a raised risk for heart disease and diabetes in teens, it did not prove a cause-and-effect relationship.
The U.S. National Library of Medicine has more about teen health (http://www.nlm.nih.gov/medlineplus/teenhealth.html ).
SOURCE: University of Michigan Health System, news release, March 6, 2014